COVID-19 vaccine effectiveness and uptake in a national cohort of English children and young people with life-limiting neurodisability.

Autor:	Cruz J; Population, Policy & Practice Research Programme, UCL GOS Institute of Child Health, London, UK., Harwood R; Paediatric Surgery, Alder Hey Children's NHS Foundation Trust, Liverpool, UK.; Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK., Kenny S; Paediatric Surgery, Alder Hey Children's NHS Foundation Trust, Liverpool, UK.; NHS England and NHS Improvement London, London, UK., Clark M; NHS England and NHS Improvement London, London, UK., Davis PJ; Bristol Royal Hospital for Children, Bristol, Select State, UK., Draper ES; Paediatric Intensive Care Audit Network, Department of Population Health Sciences, University of Leicester, Leicester, UK., Hargreaves D; Mohn Centre for Children's Health and Wellbeing, Imperial College London, London, UK., Ladhani SN; Immunisation Department, UK Health Security Agency, London, UK.; Centre for Neonatal and Paediatric Infection (CNPI), Immunisation Department, St George's University of London, London, UK., Luyt K; Bristol Medical School, University of Bristol, Bristol, UK., Turner SW; NHS Grampian, Aberdeen, Aberdeen, UK., Whittaker E; Paediatric Infectious Diseases, Imperial College Healthcare NHS Trust, London, UK.; Section of Paediatric Infectious Diseases, Faculty of Medicine, Imperial College London, London, UK., Hardelid P; Population, Policy & Practice Research Programme, UCL GOS Institute of Child Health, London, UK., Fraser LK; Cicely Saunders Institute, King's College London, London, UK., Viner RM; Population, Policy & Practice Research Programme, UCL GOS Institute of Child Health, London, UK., Ward JL; Population, Policy & Practice Research Programme, UCL GOS Institute of Child Health, London, UK joseph.ward@ucl.ac.uk.
Jazyk:	angličtina
Zdroj:	Archives of disease in childhood [Arch Dis Child] 2024 Oct 21. Date of Electronic Publication: 2024 Oct 21.
DOI:	10.1136/archdischild-2024-327293
Abstrakt:	Objective: To investigate SARS-CoV-2 vaccine uptake and effectiveness in children and young people (CYP) with life-limiting neurodisability. Design: We undertook a retrospective cohort study using national hospital data in England from 21 December 2020 to 2 September 2022 to describe SARS-CoV-2 vaccination uptake, and then examined COVID-19 hospitalisation, paediatric intensive care unit (PICU) admission and death following SARS-CoV-2 infection by vaccination status using Cox regression models. Patients: CYP aged 5-17 with life-limiting neurodisability. Results: We identified 38 067 CYP with life-limiting neurodisability; 13 311 (35.0%) received at least one SARS-CoV-2 vaccine, with uptake higher among older, white CYP, from less deprived neighbourhoods. Of 8134 CYP followed up after a positive SARS-CoV-2 test, 1547 (19%) were vaccinated. Within 28 days of infection, 309 (4.7%) unvaccinated CYP were hospitalised with COVID-19 compared with 75 (4.8%) vaccinated CYP. 46 (0.7%) unvaccinated CYP were admitted to PICU compared with 10 (0.6%) vaccinated CYP. 20 CYP died within 28 days of SARS-CoV-2 infection, of which 13 were unvaccinated. Overall, adjusted hazard of hospitalisation for COVID-19 or admission to PICU did not vary by vaccination status. When the Alpha-Delta SARS-CoV-2 variants were dominant, hazard of hospitalisation with COVID-19 was significantly lower among vaccinated CYP (HR 0.26 (0.09 to 0.74)), with no difference seen during Omicron (HR 1.16 (0.74 to 1.81)). Conclusions: SARS-CoV-2 vaccination was protective of COVID-19 hospitalisation among CYP with life-limiting neurodisability during Alpha-Delta, but not for other SARS-CoV-2 variants. Vaccine uptake was low and varied by ethnicity and deprivation. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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